• Title/Summary/Keyword: Attention Deficit Hyperactivity Disorder (ADHD)

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Treatment Adherence of Osmotic-Controlled Release Oral Delivery System Methylphenidate in Korean Children and Adolescents with Attention-Deficit Hyperactivity Disorder (주의력결핍 과잉행동장애 아동에서 Osmotic-Controlled Release Oral Delivery System Methylphenidate의 치료순응도)

  • Kim, Bongseog;Lee, Jeong-Seop;Kim, Eui-Jung;Sung, Hyung-Mo;Shin, Yun Mi;Hwang, Seong-Hye;Yoo, Hanik K.
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.25 no.2
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    • pp.65-72
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    • 2014
  • Objectives : The objective of this study was to evaluate the treatment duration and adherence of osmotic-controlled release oral delivery system (OROS) methylphenidate for treatment of attention-deficit hyperactivity disorder (ADHD). Methods : A total of 843 children with ADHD were recruited : 213 children (25.3%) who had previously taken medications for ADHD and 630 drug-na$\ddot{i}$ve children (74.7%) were recruited. The dosage was adjusted according to the clinician's judgment. The primary efficacy endpoint of this study was treatment retention rate, which was estimated at Week 12 and Week 20 using the Kaplan-Meier curve. The Swanson, Nolan and Pelham-IV (SNAP-IV), Clinical Global Impression-Severity (CGI-S), Clinical Global Impression-Improvement, and the side effect rating scale were measured at every visit. Remission rates were presented based on SNAP-IV and CGI-S, respectively. Results : The treatment retention rate at 12 weeks and at 20 weeks was 76.2% and 66.8%, respectively. Divided according to 6-8, 9-11, 12-14 and 15-18 years of age, younger children tended to show a statistically higher treatment retention rate (p=.02). Based on SNAP-IV and CGI scores, children with better response to medication showed tendencies of statistically higher treatment retention rate. The most common adverse events included loss of appetite (7.1%) and insomnia (3.3%). There was no serious adverse event related to the treatment, such as death. Conclusion : The use of OROS methylphenidate for treatment of ADHD was safe and tolerable for children. In this study, lower age and better treatment response showed a statistically significant relationship with higher treatment adherence. Boys showed a trend of high treatment adherence. The treatment adherence at 20 weeks was satisfactory, however, the treatment adherence after 20 weeks showed a sharp decrease. Therefore, treatment persistence for six months after the beginning of ADHD treatment is important. In addition, the positive role of psycho-education for children and parents is necessary for increasing treatment adherence.

Derivation of a benchmark dose lower bound of lead for attention deficit hyperactivity disorder using a longitudinal data set (경시적 자료의 주의력 결핍 과잉행동 장애를 종점으로 한 납의 벤치마크 용량 하한 도출)

  • Lee, Juhyung;Kim, Si Yeon;Ha, Mina;Kwon, Hojang;Kim, Byung Soo
    • The Korean Journal of Applied Statistics
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    • v.29 no.7
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    • pp.1295-1309
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    • 2016
  • This paper is to reproduce the result of Kim et al. (2014) by deriving a benchmark dose lower bound (BMDL) of lead based on the 2005 cohort data set of Children's Health and Environmental Research (CHEER) data set. The ADHD rating scales in the 2005 cohort were not consistent along the three follow-ups since two different ADHD rating scales were used in the cohort. We first unified the ADHD rating scales in the 2005 cohort by deriving a conversion formula using a penalized linear spline. We then constructed two linear mixed models for the 2005 cohort which reflected the longitudinal characteristics of the data set. The first model introduced the random intercept and the random slope terms and the second model assumed the first order autoregressive structure of the error term. Using these two models, we derived the BMDLs of lead and reconfirmed the "regression to the mean" nature of the ADHD score discovered by Kim et al. (2014). We also noticed that there was a definite difference between the sampling distributions of the two cohorts. As a result, taking this difference into account, we were able to obtain the consistent result with Kim et al. (2014).

Change of Quality of Life in Children with ADHD after 12 Weeks OROS-Methylphenidate Treatment (12주 OROS-Methylphenidate 약물 치료 후 ADHD 아동의 삶의 질 변화)

  • Kim, Hyung-In;Kim, Bung-Nyun;Cho, Soo-Churl;Shin, Min-Sup;Yoo, Hee-Jeong;Kim, Jae-Won;Kim, Ji-Hoon;Son, Jung-Woo;Shin, Yun-Mi;Chung, Un-Sun;Han, Doug-Hyun
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.23 no.3
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    • pp.103-108
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    • 2012
  • Objectives : The aim of this study is to investigate the effectiveness of treatment with osmotic-release oral system methylphenidate (OROS-MPH) on quality of life (QOL) in children with attention-deficit hyperactivity disorder (ADHD). Another aim is to assess the relationship between change in QOL and other factors including children's symptoms and academic performance or parents' depression and parenting stress. Methods : A total of 111 medication-naive children with ADHD in a multicenter, open-label, 12-week trial of OROS-MPH completed an evaluation using diverse rating scales at two time points; at baseline and after 12 weeks of treatment. Scales for investigation of children included the Parent Report Form-Children's Health and Illness Profile-Children's Edition (PRF-CHIP-CE) on QOL, the ADHD Rating Scale-IV on symptoms, and the Academic Performance Rating Scale (APRS). The Beck Depression Inventory and Parenting Stress Index were used for assessment of their parents. Results : Total scores for mean PRF-CHIP-CE increased from $207.9{\pm}26.7$ at baseline to $226.3{\pm}25.9$ after 12 weeks of treatment (p<.001). The change of APRS showed the strongest correlation with the increment of PRF-CHIP-CE scores (Pearson coefficient=0.561, p<.001), even after controlling for other factors (partial correlation coefficient=0.420, p<.001). Conclusion : Treatment with MPH-OROS results in improvement of QOL in children with ADHD in Korea. The advance in academic performance plays a key role in this change of QOL.

The Learning Motivation Improvement Program in Children with Attention-Deficit Hyperactivity Disorder(ADHD) (주의력결핍 과잉행동장애 아동에서 학습동기증진프로그램)

  • NamKoong, Sun;Ahn, Dong-Hyun;Lee, Yang-Hee
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.18 no.1
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    • pp.58-65
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    • 2007
  • Objectives : Motivational factor is a unique contributor to the typically poor academic performance of children with ADHD. However, few study has directly intervened learning motivation in children with ADHD. We conducted this study to explore the direct effects of the learning motivation improvement program applied to children with ADHD. Method The program was designed in order to increase an interest-inducing educational intervention, an academic skills integration, a basic learning activity (reading, writing, and math), and children's self-esteem. We conducted the program twice a week (total 10 sessions) and assessed learning motivation, teaming attitude, self-esteem, academic performance, and problem behaviors of participating children. Results : After the program, teachers reported improvement in teaming motivation. In addition, parents notified sisnificant reduction of problem behaviors. Children reported improvement in a few domains of teaming motivation and learning attitude. Conclusion : While loaming motivation is regarded as an important factor in education, there have been few studies considering this issue in both educational and psychiatric fields. The teaming motivation improvement would be needed in both field in order to reduce the deficits in academic performance in children with ADHD.

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Influences of Attention Deficit Hyperactivity Disorder and Family Variables on the Parents' Perception of Parental Role, Family Funtioning (취학전아동의 주의력결핍.과잉활동장애 및 가족변인이 부모역할, 가족기능지각에 미치는 영향)

  • 추영란
    • Journal of the Korean Home Economics Association
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    • v.33 no.5
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    • pp.241-253
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    • 1995
  • The purpose of this study was to identify how th ADHD variable and family variables influence parents' perception of parental role, family functioning. Subjects were 478 preschoolers at the ages of 3-6 and their teachers and parents. The CTRS-10, the PSI, the FACESⅢ were used. The major findings were as follows ; 1) The variables which ae influential in parental strain were shown in order of the social psychological resource variables, the ADHD variable, and the social demographic variables. The sole ADHD variable's influence was high (β=.26***, increased R2=5.4%). 2) The variables which are influential in parental mastery were shown in order of the social psychological resource variables, the ADHD variable, and the social demographic variables. The sole ADHD variable's influence was high(β=.13*, increased R2=1.5%), also. 3) The variables which are influential in family cohesion and adaptability were shown in order of the social psychological resource variables, the social demographic variables. In both family cohesion and adaptability, the sole ADHD variables' influence was insignificant(β=-.08, increased R2=-0.3%, increased R3=-0.3%). Implications to knowledges as well as recommendations for future research are discussed.

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EFFECT OF THE SOCIAL SKILL TRAINING IN ADHD CHILDREN (주의력 결핍 과잉운동장애 아동에서 사회기술훈련의 효과)

  • Park, Soon-Young;Kwack, Young-Sook;Kim, Mi-Koung
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.9 no.2
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    • pp.154-164
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    • 1998
  • Medication is widely accepted as an effective method to reduce the problem of attention deficit, hyperactivity, impulsivity, resistance and violence of ADHD children. However, it does not provide us with the solution on the conflicting routinized behavioral patterns to gain a high level of self-control and acceptable behavior. As a way of replacing medication, this study applies the social skills training program for ADHD children and measures the level of improvement of social skills and the change of the behavioral patterns. The experiment is carried out on 16 children ranged from 6 to 13 years of age for 10 weeks. The patients are divided into three groups:a pure ADHD group, an ADHD group with conduct disorder, an ADHD group with mental retardation and other symptoms. The change of symptoms and the change of social skills are measured by the Child Behavior Checklist(CBCL), the ADD-H Comprehensive Teacher’s Rating Scale(ACTeRS) and the Social Skills Rating Scale(SSRS), and finally Mastson Evaluation of Social Skills for Youth(MESSY). Wilcoxon signed ranks test is used to evaluate the effect of the treatment, and Kruskal-Wallis test is also used to measure the change after the treatment in each of the three groups. In the ADHD group with conduct disorder, the examination of the effect of the treatment shows a significant reduction of violence in the area of behavior(p<.05), and a significant difference of activity and social skills in the area of social competent(p<.001). In the ADHD group with mental retardation and other symptoms, a significant rise of social skills is found in the area of social skills evaluation (p<.05). However, there is no significant difference of effect by the treatment among the three groups. In addition, the current examination shows that the social skills training program does not make a statistically significant contribution to the social skills of the ADHD children. On the other hand, the training helps some children, when it is suitable for the characteristics and accompanying symptoms of the children:it reduces the level of violence in the ADHD group with conduct disorder, and it raises the social skills in the ADHD group with mental retardation. In other words, the social skills training program will reduce the conduct disorder and helps peer relation for ADHD children.

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Parents' Rearing Attitude of Children with Attention-Deficit Hyperactivity Disorder and Depressive Disorder (주의력결핍 과잉행동장애와 우울장애 아동 집단의 부모 양육태도)

  • Kim, So-Yeon;Hwang, Jun-Won;Kim, Boong-Nyun;Cho, Soo-Churl;Shin, Min-Sup
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.19 no.3
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    • pp.175-181
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    • 2008
  • Objectives: This study was conducted to compare the mothers' rearing attitude of ADHD children and that of children with depressive disorder. Methods: The participant consisted of 58 school-aged children diagnosed as ADHD, 14 children diagnosed as depressive disorder based on DSM-IV criteria. Normal control group consisted of 34 school-aged children who are free of any diagnosis of psychiatric disorders. Parental Acceptance-Rejection Questionnaire, Parenting Style Questionnaire, Children's Depression Inventory, Marital Satisfaction Scale, Beck's Depression Inventory were administered to all children and their mothers. Results: The parents of ADHD children showed more aggressive/hostile, neglecting/indifferent and less warm/affectionate parenting styles to their children than those of the depression and control groups. The depressive group perceived their parents as more rejecting than the control groups. Conclusion: The externalizing symptoms of ADHD might provoke parental distress and make it difficult for the parents to show positive rearing attitude toward their children. The depressive children might be more sensitive and perceptive to the negative sign of their parents' rearing attitude.

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The Scutellaria Flavone, Oroxylin A, Improves Attention-Deficit/Hyperactivity Disorder Related Behaviors in Spontaneously Hypertensive Rats

  • Yoon, Seo-Young;Chun, Mi-Sook;Lee, Yong-Soo;Park, Hae-Il;Shin, Chan-Young;Ryu, Jong-Hoon;Cheong, Jae-Hoon
    • Biomolecules & Therapeutics
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    • v.16 no.4
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    • pp.343-350
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    • 2008
  • Oroxylin A is a flavonoid isolated from Scutellaria baicalensis, which is one of the most important medicinal herbs in traditional Korean medicine. In this study, we investigated the psychopharmacological activities of oroxylin A using the open field, rota-rod, balanced wire and plus-maze tests in Spontaneously Hypertensive Rats (SHR) and Wistar Kyoto Rats (WKY). Oroxylin A reduced hyperactivity in SHR (ADHD animal model) although it tended to increase locomotor activity in WKY. Methylphenidate did not reduce hyperactivity. Oroxylin A alleviated impulsive behaviors such as rearing, the percentage of moving time to the central area and the tendency to move into an unstable condition (open area in elevated plus-maze). Methylphenidate also reduced the percentage of staying time in the central area and the tendency to move into an unstable condition. Both oroxylin A and methylphenidate enhanced motor attention in SHR and WKY. Oroxylin A antagonized the muscimol ($GABA_A$ receptor agonist)-induced $Cl^-$current and its action was similar to that of bicuculline ($GABA_A$ receptor antagonist). The effects of oroxylin A may be caused by the antagonism at the $GABA_A$ receptor. Thus, oroxylin A may be a candidate of drug for treatment of ADHD.

What Event-Related Potential Tells Us about Brain Function: Child-Adolescent Psychiatric Perspectives

  • Kim, Ji Sun;Lee, Yeon Jung;Shim, Se-Hoon
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.32 no.3
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    • pp.93-98
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    • 2021
  • Electroencephalography (EEG) measures neural activation due to various cognitive processes. EEG and event-related potentials (ERPs) are widely used in studies investigating psychopathology and neural substrates of psychiatric diseases in children and adolescents. The present study aimed to review recent ERP studies in child and adolescent psychiatry. ERPs are non-invasive methods for studying synaptic functions in the brain. ERP might be a candidate biomarker in child-adolescent psychiatry, considering its ability to reflect cognitive and behavioral functions in humans. For the EEG study of psychiatric diseases in children and adolescents, several ERP components have been used, such as mismatch negativity, P300, error-related negativity (ERN), and reward positivity (RewP). Regarding executive functions and inhibition in patients with attention-deficit/hyperactivity disorder (ADHD), P300 latency, and ERN were significantly different in patients with ADHD compared to those in the healthy population. ERN showed meaningful changes in patients with anxiety disorders, such as generalized anxiety disorder, separation anxiety disorder, and obsessive-compulsive disorder. Patients with depression showed significantly attenuated RewP compared to the healthy population, which was related to the symptoms of anhedonia.

COGNITIVE CHARACTERISTICS OF CHILDREN WITH DYSLEXIA AND/OR ATTENTION DEFICIT/HYPERACTIVITY DISORDER (읽기 장애 아동과 주의력 결핍/과잉 활동장애 아동의 인지적 특성)

  • Kim, Seung-Tai;Kim, Ji-Hae
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.7 no.2
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    • pp.224-232
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    • 1996
  • The present study was conducted to investigate cognitive characteristics of children with dyslexia and/or attention deficit/hyperacidity disorder. Cognitive characteristics were evaluated by using KEDI-WISC, the Basic Achievement Test, TOVA, MFFT, and neuropsychological tests. ADHD group showed significantly lower level of performance in response time for correct responses and presented variability for correct responses in TOVA. Dyslexia and mixed group showed lower performance in Reading I and Reading II, Writing subtest in the Basic Achievement Test than those of ADHD group and in Information subtest of KEDI-WfSC. In order rd determine the diagnostic effectiveness of each psychological tests, discriminant analysis was conducted. In this analysis, 11 subtests of KEDI-WISC and 4 variables of TOVA, 4 subtests of the Basic Achievement Test, and MFFT, WCST were included as independent variables and each diagnostic roups were dependent variables. Discriminant analysis indicated that overall percentage of correct classification was 93.88%. The clinical implifications and limitations of the present study were listed and discussed.

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